In Group
I, pain was measured at the time scale of 0, 2, 6, 24 hours, and
additionally, 20 minutes prior to each hour. 20 minutes is the time
interval before and after therapy. 0 hrs. is time which patient was
shifted to recovery room.

In Group
II, pain score was measured at time intervals of 0, 2, 6, and 24
hours only.

Results:
Group I showed a significant decrease in pain scores and the
requirement and quantity of drugs as compared to Group II.

Conclusion:The effect of Foot Reflexology causes a significant reduction of
requirement and quantity of painkillers and significant reduction of
pain score in Group I in comparison with Group II in post-operative
patients of general surgery.

Introduction:
Reflexology is the act of applying pressure on certain areas of the
hands and feet that correspond to particular organs and glands of the
body using specific thumb, finger and hand techniques without the use
of oils, lotion or creams.

The
physiological changes achieved with the application of pressure are
based on the neurological
relationship that exists between the skin and the nervous system.

Whereas,
a therapeutic effect can be achieved by stimulation at a distance
from the area where the pressure is applied. Reflexology believes
that the body is reiterated, or mirrored on the feet and hands and
works within a zonal system, as introduced by Dr. William Fitzgerald.

According
to the zone theory, the body is divided into ten equal longitudinal
zones (five on the left
side and five on the right side) running through the body from the
top of the head to the tips of the toes. If there is congestion in
any part of the body, the corresponding zone is affected. Using this
theory, we apply direct pressure to any part of the affected zone to
stimulate the entire zone.

Dr.
Riley supported the zone theory and his assistant, Eunice Ingham
plotted the reflexes of all the body areas onto the feet, thus
creating the foot map.

The
study of Reflexology is based on anatomy and physiology of the human
body. The principle of Reflexology is founded on the understanding of
how the nerves work and what they mean to the human body Reflexology
is one of the most miraculous means of utilizing a natural healing
method for maintaining the body in a post-operative condition.

Reflexology
is a non-pharmaceutical intervention. The body’s vital life force
circulates along
pathways with an estimated 800 points on the body. It is not
necessary to know all of these points since the hand as well as the
feet contain “reflex buttons” which are connected to all organs
and glands. When these reflex centers are stimulated, they instantly
send a surge of new vigor to the part of the body they are connected
to and with no
side effects.

The use
of Reflexology has increased in medical care. Recent reports include
usage in birthing, OBGYN care, post-surgical care, ICU, and patient
support.

The
International Institute of Reflexology clearly states that it does
not make any medical claims.

Theory
of Reflexology: There are over 7,200 nerve endings in each foot,
which have an extensive interconnection with the central nervous
system. These nerve endings are part of our sensory aparatus in which
they sense pain and pressure, hot and cold, etc. Reflexology
stimulates or fine-tunes this sensory apparatus and its neural
pathways. Stress patterns are also manifested on the feet. There are
many theories of Reflexology, some of which are explained here.

Applied
Theory – the foot reflects the body’s response to the stresses of
gravity and movement.

Blood
and nerve supply theory – When muscles become tense, they press on
the arteries causing sluggishness in circulation. This results in
toxins in the blood, which would normally be excreted. At these
deposits, needle shaped crystals settle in the extremities of the
hands and feet. It is believed that these deposits interrupt some
nerve impulses and cause dysfunction in the blood circulation.

Reflexology
applies pressure to break down the crystals and release them through
the excretory systems.

Pain:
Post-operative pain is attributed to the cutting of pain fibers or
irritation of pain nerve endings.

Methods
used in prevention of post-operative pain:

Conventional
Method – Painkillers such as NSAID (Diclofenac) and Opiods
(Pethidine and Fetanyl.)

Non-conventional
Method – Acupressure, Acupuncture and Reflexology.

Method:
Sixty (60) adult patients were randomly divided into Group I
(Reflexology group) and Group II (Control group).

It was
noted that there was a decrease in the requirement and quantity of
painkillers in the Reflexology Group I compared with the Control
Group II.

Pain was
monitored on a visual analog scale (VAS) of 0 to 10, with 0-5=Mild
pain, 5=Moderate pain, and 5-10=Severe pain.

Group I
received foot reflexology for 15-20 minutes sessions. Sessions began
with reflexology relaxation techniques, and thumb (thumb walking and
dig and back up) and finger (finger walking and finger rotary
pressure) working techniques.

Areas
reflexed were specific to type of surgery performed and the related
areas of pain.

Results:

Comparison
of quantity of painkillers in Group I and Group II

______________________________________________________

Time
Interval: 0 hrs. 2 hrs. 6 hrs. 24 hrs.

_______________________________________________________

Group I 65.5% 19.5%* 75% 65.5%

Group II 100% 85% 100% 100%__

P=.001
P=.001 P=.005 P=.002

*An
absolutely significant decrease of requirement of drugs in Group I.

This
study shows a decrease of the quantity of painkillers in Group 1 to
less than 50% as compared to Group II.

Under
most circumstances pain causes the greater amount of suffering,
particularly after major surgeries. In some cases, nausea and
vomiting may be distressing, particularly after minor surgery.

It is
considered that there are areas of the body that have only one or two
histological types of receptors, and yet, they are sensitive to
variety of different stimuli.

The
specific area of central nervous system to which afferent nerve fiber
pass determines the type of sensation.

For
example, if a pain nerve fiber is stimulated by heat, cold, touch,
and pressure, the individual will experience only pain.

Gating
Theory

Specific
neural pathway for specific pain fibers (A delta nerve fibers) travel
through the spinothalemic tract towards the central nervous system.
When touch and pressure is applied on specific reflex point, it would
activate slow conducting C fibers that take the same pathway thereby
inhibit the path of A delta nerve fibers and block the pain.

According
to this theory, pain signals pass through a number of traffic “gates”
as they move from the area of injury upwards through the spinal cord
to the brain.

Like a
road or highway, these nerves can handle only a limited number of
nerve signals at one time. The pain signals travel slowly. We can
generate C fibers through use of
Reflexology by applying pressure on a specific reflex point.

The
gating theory says that pain impulse can be blocked in the spinal
cord by inhibiting signals coming from touch nerve fibers due to this
relief in pain.

Reflex
Conditioning

Stimulus
– Information is sent from the foot to the brain.

Evaluation
– The brain analyzes the information.

Response
– After brain response to the recent information by sending
instruction to the entire body about how to adapt.

Transduction:
It is a process by which one form of energy (the stimuli) is changed
to another form of energy (electrochemical energy) of nerve impulse.
The stimuli when applied to the receptor, brings about a change
potential of the plasma membrane of the nerve ending. Since this
process takes place in the receptor, it is referred to as the
receptor potential. If the receptor potential is large enough, it
generates an action potential Impulse conduction is simply the
movement of action potentials along a nerve cell.

National
Institute of Health. The Integrated Approach To The Management of
Pain. J. Pain Symptom

Reflexology
Research

The
Research Study was presented to the Reflexology Association of
America

(RAA) in
its entirety by Dr. Shweta Choudhary, Dept. of Biophysics, All India
Institute of

Medical
Science (AIIMS), New Delhi, India. The following abridged version is
reprinted from the RAA magazine Reflexology Across America, Spring
2006 Edition. Dr Shweta recently completed another research study on
“The Efficacy of Reflexology for Prevention of Post- Operative
Nausea and Vomiting.”

She is
also interested in researching Reflexology for patients with cancer
and spinal problems. Dr. Shweta believes that 75% of diseases are due
to stress and tension in the body, which create an imbalance of
biochemical and endocrine functions.

Due to
Dr. Shweta’s successful work in Reflexology research, more
physicians and